title: Examining the structural challenges to communication as experienced by nurse managers in two US hospital settings.
abstract: OBJECTIVE
  This study examined the structural barriers to communication for first-line nurse managers with their staff nurses.
  
  
  BACKGROUND
  The delivery of quality care depends on effective communication in hospital units. First-line nurse managers are central figures in networks whose responsibility is to communicate information from the senior management to staff nurses.
  
  
  METHODS
  The data were collected using face-to-face interviews with first-line managers at two US hospitals The interviews were transcribed and coded with limited use of the qualitative software atlas Interview questions focused on work experiences of managers with special emphases on communication.
  
  
  RESULTS
  Structural barriers that influenced managers' communication included the amount of face-to-face interaction with nurses, the amount of information to communicate, levels of formalization, outreach to all nurses, time constraints and nurses' subcultural networks These factors compromised managers' ability to communicate effectively with nurses.
  
  
  CONCLUSIONS
  Managers should carefully examine how structure affects communication recognizing that some dynamics of structure cannot be changed but that they can influence others, such as formalization and communication networks.
  
  
  CONCLUSIONS
  Managers should examine their own positioning within nurses' networks and demonstrate to nurses that their expertise contributes to the collaborative capital upon which nursing practice depends.
authors.affiliation: Department of Sociology, California State University, San Bernardino, San Bernardino, CA, USA.
authors.forename: Marcia
authors.initials: M
authors.lastname: Marx
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D006761:Hospitals / Q000592:standards*; D006801:Humans; D007588:Job Satisfaction; D009718:Nurse Administrators / Q000523:psychology*; D014481:United States
keywords: collaborative capital; communication; first-line manager; networks; subcultural fracturing